This application describes a five-year plan of training and development for the candidate who will refocus her clinical psychology career from service and program administration to patient-oriented bio-behavioral research in sickle cell disease. This transition will occur under the primary mentorship of Dr. Tom Boyce, a highly-regarded expert in psychobiological reactivity and health outcomes. Dr. Lori Styles, an accomplished basic and clinical researcher in sickle cell disease, will serve as co-mentor. Both sponsors have mentored a number of scientists who have gone on to independent careers in biomedical research. The training program will integrate resources from the University of California-Berkeley and Children's Hospital and Research Center at Oakland, as well as diverse concepts and methods from the fields of medicine and psychology. The candidate's collaborators will supplement her training by lending their expertise in autonomic reactivity, biomedical science and psychiatry. An advisory committee of clinical scientists with distinguished contributions to psychological and medical research in sickle cell disease will provide guidance to the candidate as she broadens her focus to an academic research career. The research plan will focus on psychobiological reactivity in response to laboratory challenge, a novel individual difference variable that integrates physiological and psychological factors, for a cohort of pediatric patients with sickle cell disease. In our pilot study, a measure of autonomic reactivity was the only variable among those studied that bore a strong association with clinical disease severity for young children with sickle cell disease. The aims of the proposed research are to: (1) evaluate psycho-biological reactivity as a robust predictor of sickle pain, defined as rate of painful episodes and daily pain frequency and intensity, for children ages five to twelve with sickle cell disease;and (2) to evaluate the independent and combined influences of physiological and psychological factors on outcomes for children with sickle cell disease. This study will offer new insight into predictors of outcomes for SCD that can in turn inform the design of more effective interventions. The strengths of the institutions and the candidate combined will maximize the candidate's potential for the successful transition into a career as an independent biobehavioral scientist. (End of Abstract)